Effects of fixed orthodontic appliances on subgingival microflora

Abstract

The therapy with fixed appliances may transitionally increase the growth of periodontopathogenic bacteria and consequently result in gingival inflammatory response but without destructive effect on deep periodontal tissues.

Changes in oral microbiota due to orthodontic appliances: a systematic review

“…Of the 29 articles that studied CB [3,4,10,12,13,19–23,26–30,32,34,35,38,41,44,46–48,50,51,54,44,57], the majority showed a significant increase in BOP and PI. Two studies [10,52] investigated the differences between the use of elastomeric or steel ligatures, revealing contradictory results on BOP and PI at different times.…”

“…Two studies [10,52] investigated the differences between the use of elastomeric or steel ligatures, revealing contradictory results on BOP and PI at different times. Ristic’s studies [44,45] highlighted that maximum values of PI and BOP were reached 3 months after appliance placement, followed by a decrease in these parameters 6 months after treatment began. Six studies assessed the increase of Candida at different times [12,13,22,23,56,57].…”

“…[3,4,12,19–21,27–30,32,34,35,42,46,47,50,51,54,57]. Three studies [43,44,48] detected significant increases of gram-negative bacteria, respectively, at 3 and 6 months, followed by a decrease at 6 and 12 months. Ten studies [10,20,21,26,30,37,41,43,44,48] detected an increase in the percentage of gram-bacteria and A. actinomycetemcomitans .…”

“…Three studies [43,44,48] detected significant increases of gram-negative bacteria, respectively, at 3 and 6 months, followed by a decrease at 6 and 12 months. Ten studies [10,20,21,26,30,37,41,43,44,48] detected an increase in the percentage of gram-bacteria and A. actinomycetemcomitans . The study conducted by Alves de Souza et al [10] revealed a significant increase in gram-species with the use of elasticomeric rings (Table 5).…”

“…Oral microbiota alterations registered in orthodontic patients appear to be consistent with the modifications occurring in patients with poor oral hygiene presenting gingivitis and/or periodontal diseases. In addition, orthodontic devices could represent a direct risk factor for periodontal diseases as they are often related to an increase in periodontopathogenic species [24,34,43,44,48]. However, it seems reasonable to state that the susceptibility of each subject, as well as other factors that may alter the biofilm balance, may play a key role in determining the entity of periodontal sequelae.…”